Subnormal weight, or an extreme underweight condition is, as a rule, associated with impaired health. A normal weight condition is usually characterized by the right proportions of muscles, fat, and other structures that cover the skeleton of the body. Extreme thinness is caused by the inability of the body tissues to assimilate food materials into their own substances. Thin persons may eat even to the point of distress, yet they fail to gain-until they are treated gently and wisely. By that I mean that the underweight person must be recognized as a sick person.
There may be emotional factors that are important in disturbing physiological relationships between the body and the food eaten. A depressed state of mind in those who are inclined to take things very seriously may modify body chemistry to the point of affecting the organism by causing a wasting of its structures. I have seen many such cases. When I treat underweight young children or even infants, emotional or psychological or mental causes are, of course, not likely to be a factor. An emaciated baby is often one that has been started on a rich formula that it cannot digest.
Inability to digest causes bodily disturbances that keep the victim thin and miserable. The underweight person, young or old, fails to assimilate fluids, among other things. One of the basic symptoms accompanying underweight is poliuria. Day and night the kidneys and bladder are at work eliminating the liquids that are taken in, and more besides- The body of the thin person seems to be so dehydrated that even solid foods are drained of their fluids, which are then passed off by the kidneys.
The bowels of the underweight individual are, in some cases, dry and constipated, and in many cases colitis is present.
In these cases natural therapeutics, as a rule, give the best results. Drugs invariably fail. In young people, in infants or children, it is comparatively easy to correct this disturbance of nutrition. The patient must be studied and made comfortable. A complete rest cure is to be followed. The food intake must be correlated with appetite and physical comfort. The greatest wisdom must be exercised in starting the day right.
A breakfast consisting of a few bites of food too much may start the victim of underweight on a miserable day. The breakfast should therefore be very light and small: to begin with, a small amount of liquid, whatever is most relished. By liquid I mean water or fruit juices with water. Milk is really a semi-solid, because in the process of digestion in the stomach it turns into a substance of a “Junket-like” consistency. If there is appetite in the morning for a starchy food such as toast or well-cooked cereal with a little butter (with no sweetening of any kind), well and good. If, however, there is any distress of the stomach or intestines-such as gas pressure, sour or bitter taste, or a constipated stool-do not feed any starch until the lower bowel. has been cleansed with a low enema of lukewarm water.
If the stool is very dry and lumpy, warm mineral oil may be injected into the rectum through a bulb syringe to soften those fecal lumps. In the case of one child, I have encountered an accumulation of fecal lumps up to the size of an orange that could be plainly out-lined by a digital examination of the rectum. When there is any bowel distress, the breakfast should consist of half water and half milk, or hot lemonade with honey for older individuals. A warm moist pack on the abdomen for about two or three hours will be a welcome treatment for child or adult.
The noon meal may consist of a starchy food or one protein. The protein may be one egg, or an ounce or two of fresh cottage cheese, or a glass of milk. This may be followed with cooked leafy or other green vegetables, with butter or sweet cream, and fresh or stewed fruit for dessert. After this meal should come a rest period and if possible a nap. The underweight person must indeed “vegetate,” or rest and sleep without worrying.
In the case of an older individual with an underweight problem it is sometimes necessary to go into the emotional and psychological aspects of the patient. Worry, anxiety, and other feelings of depression are very harmful to those who are thin. All sorts of mental states may develop, neuroses of various types, fears and phobias, that would not arise in the same individual if he were well and strong. Where such problems seem to exist, the physician must devise ways and methods of building up the morale and courage of the patient.
There are many people who walk around chronically tired who are also thin. In order to build up their weight they must get rid of the tired feeling. To work out a days schedule for the thin patient, it is necessary to establish an easy routine of living for days and days, until weight is markedly on the upgrade. Those who must go to work, though they are underweight, must work out a schedule that includes going to bed no later than 9 p.m.
Sometimes the thin individual suffers from insomnia. If the evening meal has been a light one, like the noon meal, another meal may be taken before retiring. I do not believe in drinking milk before retiring when a four- or five-course meal has been taken for dinner.
The thin person does best on two- or three-course meals. An underweight person will also digest food best when asleep. A full stomach is conducive to sleep. In some cases it is advisable to feed an underweight person the heaviest meal before retiring. A heavy meal is a dish of cooked brown cereal, such as rice, Wheatena, or dry shredded wheat, with a little sweet cream.
The thin individual often suffers from cold extremities. A hot water bag or an electric pad placed on the feet, as well as adequate blanket covers, will solve that problem. One should warm the feet up quickly with artificial heat rather than wait for the body to warm them naturally. The latter is one way of robbing the body of energy that may be needed for digesting and assimilating food. A foot-warmer is indeed a help to digestion and assimilation.
As for bathing for the underweight: showers may be shocking; tub baths may be tiring; the recourse is a rub-down with a damp towel followed by a dry towel, and this should be done while sitting rather than standing, or while lying down and at the same time giving the body an air bath.
The foregoing suggestions for the thin and underweight should do much good when applied to the letter. I have treated many under-weight patients, ranging in age from a 19-month-old baby to a 93-year-old man, and they all gained weight. In-between these extremes, my patients have included young women, young men, and middle-aged individuals from all walks of life. One of my interesting cases in this connection was a young woman, the wife of a doctor (MD).
In all the cases that I treated, I put my working principles into practice consistently and strictly, and thus I succeeded in helping my patients. It is gratifying indeed to observe the changes for the better in the personality of the patient who regains weight. A new world, a world full of hope and ambition and optimism, opens up to the person who has regained lost weight.